Cardiac Vascular Nursing Exam Technology & Digital Applications 5 — Questions and Answers
Question 1: A cardiac nurse uses a clinical decision support (CDS) tool integrated in the EHR that flags a patient's estimated glomerular filtration rate (eGFR) of 28 mL/min before administering contrast for a cardiac CT. What is the priority nursing response?
- Administer contrast as scheduled since the CDS alert is optional
- Notify the ordering provider and hold contrast pending nephrology or physician review (Correct answer)
- Administer a reduced contrast dose without notifying the provider
- Ignore the alert if the patient has no history of kidney disease
Correct answer: Notify the ordering provider and hold contrast pending nephrology or physician review
An eGFR of 28 mL/min represents significant renal impairment and a high risk for contrast-induced nephropathy; the provider must be notified and contrast held pending review.
Question 2: Which wireless technology standard is most commonly used for real-time transmission of implantable cardiac monitor (ICM) data to the clinic's digital platform?
- Bluetooth Low Energy (BLE) and cellular network transmission (Correct answer)
- Traditional radio frequency (RF) only
- Infrared data transfer
- USB direct download at each clinic visit only
Correct answer: Bluetooth Low Energy (BLE) and cellular network transmission
Modern implantable cardiac monitors use Bluetooth Low Energy to communicate with a bedside transmitter or smartphone, which then uploads data to the clinic via cellular or Wi-Fi networks.
Question 3: A vascular nurse uses a digital ankle-brachial index (ABI) device to assess a patient with suspected peripheral artery disease. An ABI result of 0.55 is obtained. How should the nurse interpret this finding?
- Normal perfusion — no further action needed
- Severe arterial disease — report to provider for urgent vascular evaluation (Correct answer)
- Mild arterial disease — recheck in 6 months
- Venous insufficiency — recommend compression therapy
Correct answer: Severe arterial disease — report to provider for urgent vascular evaluation
An ABI below 0.60 indicates severe peripheral arterial disease with significantly reduced limb perfusion, requiring prompt vascular surgical evaluation.
Question 4: A nurse caring for a patient on a left ventricular assist device (LVAD) checks the controller's digital display and notes the 'Low Flow' alarm is active. What is the first clinical assessment priority?
- Replace the LVAD controller immediately
- Assess the patient for hypovolemia, arrhythmia, suction events, or driveline malfunction (Correct answer)
- Increase the LVAD speed setting without assessment
- Silence the alarm and document the time
Correct answer: Assess the patient for hypovolemia, arrhythmia, suction events, or driveline malfunction
A Low Flow alarm on an LVAD controller indicates reduced device output and requires systematic patient assessment for correctable causes before any device adjustments.
Question 5: When using a point-of-care activated clotting time (ACT) analyzer during cardiac catheterization, at what ACT value is adequate anticoagulation with unfractionated heparin typically confirmed for PCI?
- ACT 100–150 seconds
- ACT 200–250 seconds
- ACT 300–350 seconds (Correct answer)
- ACT >400 seconds
Correct answer: ACT 300–350 seconds
For PCI with unfractionated heparin alone, a target ACT of 300–350 seconds provides adequate anticoagulation to prevent catheter-related thrombosis while balancing bleeding risk.
Question 6: A cardiac telemetry nurse notices the central monitoring station's artifact filter is disabled. Which rhythm could be most dangerously MISSED because of excessive artifact on the display?
- Sinus bradycardia at 55 bpm
- Coarse ventricular fibrillation (Correct answer)
- First-degree AV block
- Junctional escape rhythm
Correct answer: Coarse ventricular fibrillation
Coarse ventricular fibrillation can mimic artifact; with the filter disabled, excessive motion artifact may obscure or mimic VF, delaying recognition and life-saving defibrillation.
Question 7: A nurse accesses a patient's digital care plan via the hospital's mobile application on a personal smartphone. Which security measure is most critical to protect patient data on this device?
- Using the hospital Wi-Fi only when charting
- Enabling remote wipe capability and using a strong PIN or biometric lock on the device (Correct answer)
- Storing patient information in a personal note-taking app for convenience
- Keeping the mobile app open for faster access between tasks
Correct answer: Enabling remote wipe capability and using a strong PIN or biometric lock on the device
Remote wipe capability combined with biometric or PIN authentication ensures that PHI can be secured or erased if the personal device is lost or stolen.
Cardiac Vascular Nursing Exam Technology & Digital Applications 5
A cardiac nurse uses a clinical decision support (CDS) tool integrated in the EHR that flags a patient's estimated glomerular filtration rate (eGFR) of 28 mL/min before administering contrast for a cardiac CT.
What is the priority nursing response?